The Ontario Tobacco Research Unit (OTRU) is recognized as a Canadian leader in
tobacco control research and training, and as a respected source of
science-based information on tobacco control. In each issue of
Tobacco Info, OTRU’s Michael Chaiton reviews the latest groundbreaking
tobacco studies around the world. For more information, visit www.otru.org

Tobacco and substance use

The results of a Youth Smoking Survey revealed that it is rare to find youth who
had used tobacco or drugs without also using alcohol. Out of 45,425 Canadian
youth who were surveyed, alcohol was the most prevalent substance used. The
study was published in the journal Addictive Behaviors by Leatherdale and
Burkhalter. The researchers found that by grade 12, the majority of students
were current users of alcohol, tobacco or drugs. Future research should consider
developing a better understanding of how to prevent substance use among this
population.

Patio smoking

A study in Athens, Georgia looked at whether exposure to secondhand smoke on bar
patios can lead to measurable increases in biomarkers of tobacco exposure. The
study, published in Environmental Health Perspectives, tested urinary and
salivary cotinine (a biomarker that reveals exposure levels to tobacco smoke) of
non-smokers assigned to sit either outside a bar or restaurant, or an open-air
site with no smokers, collecting samples before and after the visit. Non-smokers
who sat outside the bar had elevated levels of salivary and urinary cotinine.
The authors conclude that such exposures may increase risks of health effects
associated with tobacco carcinogens.

U.S. warnings

David Hammond and colleagues evaluated the 36 specific health warnings proposed
by the U.S. Food and Drug Administration in 2010 in the journal Nicotine and
Tobacco Research. They used web-based surveys of 783 adult smokers and 510
youth in the United States. Participants were randomized to view and rate two
sets of six to seven warnings, each set corresponding to one of nine health
effect statements required under the Tobacco Control Act. Comparisons
between specific elements indicated that warnings were perceived as more
effective if they were: full colour (vs. black and white), featured real people
(vs. comic book style), contained graphic images (vs. non-graphic), and included
the number for a quitline, or personal information. Generally, smokers of all
demographics rated the warnings similarly, although youth tended to rate
warnings as more effective.

Smoking Cessation

The effectiveness of STOP (Smoking Treatment for Ontario Patients) and nicotine
replacement therapies (NRT) for smoking cessation at the population level were
analyzed by the Centre for Addiction and Mental Health and OTRU. Published in
Tobacco Control, the authors compared the quit rates of 13,143 smokers
enrolled in an Ontario program to distribute free NRT, brief advice, and
self-help materials via a toll-free number with a concurrent non-intervention
cohort of Ontario smokers matched for eligibility. The program was found to be
very effective as smokers who called the quitline were nearly twice as likely to
be abstinent at six months.

Inequalities

Wealthier men are less likely to be smokers in all regions across the globe
according to a major study examining the relationship of tobacco to
socioeconomic status worldwide. Harper and McKinnon in Cancer Causes and
Control used data from 50 countries that participated in World Health
Surveys in 2002-2003. In some countries, however (Georgia, Mexico, Mauritania),
current smoking was greater among the more advantaged. For women, smoking was
more prevalent among the poor in Europe, but more common among richer women in
Southeast Asia and the Western Pacific. The authors conclude that the
relationship between socioeconomic position and smoking in poorer countries is
dynamic and may not reflect the historical pattern in wealthier countries.